Predicting outcomes using the National Trauma Data Bank: optimum management of traumatic blunt carotid and blunt thoracic injury.

Overview

INTRODUCTION: We used the National Trauma Data Bank (NTDB) to examine the incidence of blunt thoracic and carotid trauma nationally and survival outcomes based on treatment approach. METHODS: All vascular traumas were identified from the 2008 NTDB. International Classification of Diseases, 9th Revision (ICD-9) diagnosis coding was used to identify 178 blunt thoracic aortic injuries and 313 traumatic blunt carotid injuries. RESULTS: In all, 2089 vascular traumas were identified. Patients with blunt thoracic trauma within the highest injury severity score (ISS) range (61-75) had a significant survival advantage when observation was compared with endovascular management (P < .05). In the carotid trauma cohort, those with the highest ISS range (61-75) had a significant survival advantage with open surgery compared with observation (P < .01). CONCLUSION: Patients with traumatic blunt thoracic injury and an ISS > 61 appeared to benefit from endovascular approaches compared with open management. Patients with blunt carotid trauma and an ISS > 61 appeared to benefit from open surgical management.